This page is part of the US Drug Formulary (v2.0.1: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
: Codes for medication drug tiers in health plans - XML Representation
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<CodeSystem xmlns="http://hl7.org/fhir">
<id value="usdf-DrugTierCS-TEMPORARY-TRIAL-USE"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">generic<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-generic"> </a></td><td>Generic</td><td>Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.</td></tr><tr><td style="white-space:nowrap">preferred-generic<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-preferred-generic"> </a></td><td>Preferred Generic</td><td>Commonly prescribed generic drugs.</td></tr><tr><td style="white-space:nowrap">non-preferred-generic<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-non-preferred-generic"> </a></td><td>Non-preferred Generic</td><td>Generic drugs that cost more than drugs in ‘generic’ tier.</td></tr><tr><td style="white-space:nowrap">specialty<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-specialty"> </a></td><td>Specialty</td><td>Drugs used to treat complex conditions like cancer and multiple sclerosis. They can be generic or brand name, and are typically the most expensive drugs on the formulary.</td></tr><tr><td style="white-space:nowrap">brand<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-brand"> </a></td><td>Brand</td><td>Brand name drugs that cost more than ‘preferred brand’ drugs.</td></tr><tr><td style="white-space:nowrap">preferred-brand<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-preferred-brand"> </a></td><td>Preferred Brand</td><td>Brand name drugs</td></tr><tr><td style="white-space:nowrap">non-preferred-brand<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-non-preferred-brand"> </a></td><td>Non-preferred Brand</td><td>Brand name drugs that cost more than ‘brand’ drugs.</td></tr><tr><td style="white-space:nowrap">zero-cost-share-preventative<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-zero-cost-share-preventative"> </a></td><td>Zero cost-share preventative</td><td>Preventive medications and products available at no cost.</td></tr><tr><td style="white-space:nowrap">medical-service<a name="usdf-DrugTierCS-TEMPORARY-TRIAL-USE-medical-service"> </a></td><td>Medical Service</td><td>Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.</td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="phx"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="trial-use">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/us/davinci-drug-formulary/ImplementationGuide/hl7.fhir.us.davinci-drug-formulary"/>
</extension>
</valueCode>
</extension>
<url
value="http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE"/>
<version value="2.0.1"/>
<name value="DrugTierCS"/>
<title value="Codes for medication drug tiers in health plans"/>
<status value="active"/>
<experimental value="false"/>
<date value="2023-12-01T22:20:12+00:00"/>
<publisher value="HL7 International / Pharmacy"/>
<contact>
<name value="HL7 International / Pharmacy"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/medication"/>
</telecom>
<telecom>
<system value="email"/>
<value value="pharmacy@lists.HL7.org"/>
</telecom>
</contact>
<description
value="Codes to represent the drug tier of a particular medication in a health plan. Base set are examples. Each plan may have its own controlled vocabulary."/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<caseSensitive value="true"/>
<content value="complete"/>
<count value="9"/>
<concept>
<code value="generic"/>
<display value="Generic"/>
<definition
value="Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier."/>
</concept>
<concept>
<code value="preferred-generic"/>
<display value="Preferred Generic"/>
<definition value="Commonly prescribed generic drugs."/>
</concept>
<concept>
<code value="non-preferred-generic"/>
<display value="Non-preferred Generic"/>
<definition
value="Generic drugs that cost more than drugs in ‘generic’ tier."/>
</concept>
<concept>
<code value="specialty"/>
<display value="Specialty"/>
<definition
value="Drugs used to treat complex conditions like cancer and multiple sclerosis. They can be generic or brand name, and are typically the most expensive drugs on the formulary."/>
</concept>
<concept>
<code value="brand"/>
<display value="Brand"/>
<definition
value="Brand name drugs that cost more than ‘preferred brand’ drugs."/>
</concept>
<concept>
<code value="preferred-brand"/>
<display value="Preferred Brand"/>
<definition value="Brand name drugs"/>
</concept>
<concept>
<code value="non-preferred-brand"/>
<display value="Non-preferred Brand"/>
<definition value="Brand name drugs that cost more than ‘brand’ drugs."/>
</concept>
<concept>
<code value="zero-cost-share-preventative"/>
<display value="Zero cost-share preventative"/>
<definition
value="Preventive medications and products available at no cost."/>
</concept>
<concept>
<code value="medical-service"/>
<display value="Medical Service"/>
<definition
value="Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit."/>
</concept>
</CodeSystem>
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